Skip to main content
#
Call Us Here
About Us
Carriers Represented
Contact Us
Home
Auto Insurance
Condo Insurance
Flood Insurance
Homeowners Insurance
Manufactured Homes Insurance
Motorcycle Insurance
Renters Insurance
Umbrella Insurance
Personal Insurance
Life
Health
Disability
Long Term Care
Dental
Life & Health
Employee Benefits
Annuity
Group Plans
Estate Planning
Financial Services
Customer Service
Free Quotes
Links
Insurance Resources
 Property Loss Notice 
Property Loss Notice

Contact Information
Your Full Name:
(as listed on policy now)
Your Email Address:
Daytime Telephone Number:
Description of Loss
Time & Date of Loss:
Time AM PM
Date
Location:


Description of Loss:
Police or Fire Department:
Notified?
Yes No
If Yes, Please Specify:

Is Property Habitable?:
Yes No
If No, Where Are You Staying:
or Planning to Stay?
(Please include Address &
Telephone #'s you can be reached at):
Mortgagee or Bank Information

Please Note: Submitting this form via the website does not constitute a "formal" claim. Please contact us or your insurance company to notify of a loss.

 
Insurance That Grows With You

Klemme Insurance Services
PO Box 81149
Midland, TX 79708


 Phone: (432) 687-5646      fax: (432) 684-4428
 email: 
bob@klemmeinsurance.com  

READ OUR PRIVACY STATEMENT

Some Content Provided By: © Insurance Information Institute, Inc. - Used With Permission ALL RIGHTS RESERVED -

Powered By: Insurance Web Designs
websites for insurance agents